Health

Restraining high-risk patients sometimes a necessary evil: Shekter

By AdvocateDaily.com Staff

Health-care staff are caught between a rock and a hard place when it comes to the restraint of high-risk patients, says Toronto health lawyer Brooke Shekter.

The Hamilton Spectator recently reported on the case of a man who launched a human rights complaint against a local hospital for his treatment during a mental health crisis.

The man is seeking $25,000 from the facility and police in compensation for the “mental trauma” and humiliation he suffered while handcuffed and barefoot in the busy public waiting room, surrounded by police officers and security guards, the Spectator reported.

“I was in need of respect and privacy,” the man told the newspaper of his 15-minute ordeal. “I didn’t need an audience.”

Shekter, associate with TTL Health Law, tells AdvocateDaily.com that she has sympathy for the man’s plight, but hospital staff are placed in a difficult position when patients present an apparent danger to themselves or others.

“If he hadn’t been restrained and then hurt someone, the hospital could have been blamed,” she explains. “It’s understandable that he would have been embarrassed. But at the same time, in a publicly funded health-care system like ours, when you go to the emergency room you must expect to wait, and the amount of time it takes is necessarily dictated by the severity of your condition.

“There is no other way for our system to operate in order for health professionals to deliver timely and efficient health care to patients. And anyone who has any experience with an emergency room in Ontario knows that 15 minutes is, quite frankly, a very short period of time in the grand scheme of things,” Shekter adds.

Indeed, the Spectator report noted that a senior hospital official who apologized to the man was unable to guarantee that a similar situation would not recur due to the limited space available for psychiatric emergency patients.

“It would depend on the number of people who came in at the same time,” she explained to the newspaper, which also reported that doctors have previously expressed concerns about the small size of the psychiatric ER and the unfairness to high-risk patients of being forced to wait in the general waiting room.

According to the story, the man, who suffers from a series of diagnosed conditions, including agoraphobia and borderline personality disorder, was brought to the hospital by police officers who detained him under the Mental Health Act following a threat to kill himself at his workplace.

On arrival, the story said triage nurses characterized his behaviour as aggressive and assessed his risk as moderate to high, but he ended up in the general waiting room before being moved to an exam room. His human rights complaint alleges he was discriminated against on the basis of his mental health disability, and he told the paper the experience made him less likely to seek emergency treatment.

“I think we have to be careful about setting a precedent for what’s humiliating in the context of an ER waiting room,” Shekter says. “It’s a place of horrible trauma where people are embarrassed all the time.”

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